Appendicular diverticulosis complicated by acute appendicitis and organizing abscess: what does the surgeon need to consider intraoperatively?

Acute appendicitis is a common surgical emergency, affecting 7%-10% of people worldwide, whereas appendicular diverticulosis is rare, occurring in 0.004%-2.1% of appendectomy cases and often mimicking appendicitis symptoms. A 35-year-old male presented with right lower quadrant pain, nausea, vomiting, and diarrhea. Clinical examination showed tenderness in the right iliac fossa. Imaging suggested uncomplicated acute appendicitis, but surgery revealed an appendiceal mass suspected to be a carcinoid tumor. Histopathology post-appendectomy diagnosed appendicular diverticulosis complicated by acute appendicitis. This case emphasizes the need for thorough histopathological examination in appendectomy cases to accurately diagnose and differentiate appendicular conditions. Appendiceal diverticulitis should be considered in the differential diagnosis of right lower quadrant pain to ensure proper surgical intervention and prevent complications.